Lamaze Healthy Birth Practice #5: Get Upright and Follow the Urge to Push

Lamaze Healthy Birth Practice #5: Get Upright and Follow the Urge to Push

Born to birth. Trust your team. One at a time. 

That’s the mantra that slipped onto the page while emailing with a client recently. And it applies to every part of labor. Labor is not meant to be a medical event. It’s not meant to be a solo event. And, unlike the marathons that labor is often compared to, you get natural breaks in labor – which you don’t get when running continuously for 26.21 miles – so you only have to do one contraction at a time.

What comes to mind when you think of a woman giving birth? For many parents-to-be who have yet to experience labor, their minds go straight to the Hollywood version of birth. A mom in pain, a partner unsure of what to do, water breaking in the elevator, a 5 minute labor, a bossy nurse, lots of hook ups, and last but not least, a mom pushing flat on her back while holding her breath. Aside from the 5 minute labor part (and maybe the bossy nurse), there are some births that look like this. So the question is, “Is that what you want your labor to look like?”

As educators and doulas, we often quote the famous line, “If you don’t know your options, you don’t have any.” This is very true. The other half of that important concept, however, is “Do you have access to those options?” 

Let’s look at this mantra a little closer, and then I’ll get where I’m going with the Lamaze Healthy Birth Practice #5…

  1. Born to birth. Your body, as a woman, was designed to give birth. If you are feeling unsure about that, take some time to read Ina May’s Guide to Childbirth, by Ina May Gaskin or spend some time learning about Gail Tully’s concepts for birth and baby positions at Amazing. You were born to birth.
  2. Trust your team. Find yourself a reputable, normal birth oriented childbirth class, preferably not taught in a hospital or doctor’s office. A class where you will learn about birth, not just about labor. If you wonder where to find a class like this, check out the Lamaze website for an instructor near you, at Lamaze instructors teach about normal, natural birth. Not as opposed to un-normal or unnatural, but within the context of what your body was designed to do first. In this kind of class, they will also share with you about all of your options for birth, using class time to walk through the evidence based research on primary interventions and procedures. Use this experience to help you figure out what you are open to and hope for during your birth, and then surround yourself with a provider, place of birth, doula, and a primary support team that understands and encourages you in these areas. Talk with your team – know that you can trust them to support you in the kind of birth that you hope for.
  3. One at a time. Birth can be long, like a marathon. It can be quick, like a rain storm. It can be so many things. But here’s what you don’t have to focus on – how much time is ahead of you. Your job, Moms, is to do one wave, one surge, one contraction at a time. That’s all you have to focus on. Just one.

So, how does this apply to the Lamaze Healthy Birth Practice #5: Get Upright and Follow the Urge to Push? When you get these first ducks in a row,  you’ll find in that last stage of labor you’re closer to being supported with these healthy steps to birthing your baby with confidence:

  • Follow your body’s natural urge to push. Gail Tully of Spinning Babies says, “10 is just a number. If the baby’s head isn’t there, it doesn’t mean anything.” When your baby moves down and you feel an incontrollable urge to bear down and push, you will know. I promise, you won’t miss it! Getting to this point in labor for a mom sometimes takes time though. It’s key that you’re supported by a provider who understands this and wants to support you in this manner. Just because you’re 10 cm, doesn’t always mean you’re ready to start pushing. Follow your body’s natural urge to push.
  • Being upright during the pushing stage of labor not only utilizes gravity to help you, but it’s also often less stressful for baby. When you’re upright, you tend to get into positions like squatting, that can open your pelvis by as much as 30% more, creating lots of space for baby. Here are some positions to try:
    • Standing
    • Squatting
    • Kneeling
    • Hands and Knees
    • Side Lying ( If you are tired or your legs feel shaky and you feel the need to lie down, try a side lying position with help from your support team to hold your leg.
  • Breathing your baby down (making guttural noises while you push as opposed to long lengths of holding your breath), short breath holding, and spontaneous pushing are also known to reduce the risk of episiotomies and tears to the perineum. When you first feel the urge to push, typically just at the peak of a contraction, try using the words, ‘Pop-pop-pop-pop’ over and over again in a loud voice. Sing it if you need to! Ease your way over those pushy peeks until you feel a strong urge to push. Then, when you do, bear down in a way that feels positive to you. At the end of each contraction, blow ‘horse lips’ to loosen the tension in your jaw and neck. This will also allow you to be more relaxed during the break between pushes, in order to save your energy.
  • Vary your positions. You don’t have to stay in one position for pushing. Although it’s hard to transition to a new position, sometimes the difference in how it feels for you makes it totally worth while. If one pushing position isn’t working for you, try another one. Switching it up is good for your muscles, conserving strength, and encouraging baby to move on down the canal.

You can do this! Born to birth. Trust your team. One at a time.

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Written by Julia Sittig, MSW, AdvCD(DONA), BDT(DONA), LCCE